We have studied 150 women undergoing elective Caesarean section under spinal anaesthesia. They were allocated randomly to have a 22-gauge Whitacre, a 25-gauge Whitacre or a 26-gauge Quincke needle inserted into the lumbar subarachnoid space. The groups were compared for ease of insertion, number of attempted needle insertions before identification of cerebrospinal fluid, quality of subsequent analgesia and incidence of postoperative complications. There were differences between groups, but they did not reach statistical significance. Postdural puncture headache (PDPH) was experienced by one mother in the 22-gauge Whitacre group, none in the 25-gauge Whitacre group and five in the 26-gauge Quincke group. Five of the six PDPH occurred after a single successful needle insertion. Seven of the 15 mothers in whom more than two needle insertions were made experienced backache, compared with 12 of the 129 receiving two or less (P < 0.001). We conclude that the use of 22- and 25-gauge Whitacre needles in elective Caesarean section patients is associated with a low incidence of PDPH and that postoperative backache is more likely when more than two attempts are made to insert a spinal needle.

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& Genauigkeit und Integrität (keine gü ltige Stimme kann verändert/gelö scht werden, keine ungü ltige Stimme wird als gü ltig gezählt); Manipulationen sind entdeck-und korrigierbar; die elektronisch gesammelten Stimmen werden

Electronic Transactions over the Internet, particularly using the World Wide Web have become an integral part of economic life. Recently also the public sector has started to use the new medium for its administrative processes. This paper analyses several approaches to implement an electronic voting system and discusses them with a view to voter anonymity and protection from manipulations. The paper then develops an algorithm designed to guarantee anonymity of the voter and to avoid the risk of manipulation of votes. The algorithm is based upon the strict separation of voter registration and submission of votes, which implies that certain information has to be stored on a secure media. The paper discusses the security criteria and possible implementation options for such secure storage.